Trump just revealed a deep misunderstanding of what it means to be transgender

On Wednesday, President Donald Trump
announced in a series of tweets that the US military would no
longer accept transgender people.

His announcement signals a reversal of President Barack
Obama's 2016 decision to allow transgender people to serve. After
a trial period that ended July 1, Secretary of Defense James
Mattis delayed the full implementation of that policy for six
months.

"Our military must be focused on decisive and overwhelming
victory and cannot be burdened with the tremendous medical costs
and disruption that transgender in the military would entail,"
Trump tweeted.

The RAND Corporation, a think tank, estimated
in 2016 that there were between 1,320 and 6,630 transgender
personnel in the active component of the military (out of about
1.4 million) and about 1,510 in the
reserves. It is not yet clear whether those in
the military who came out as transgender after Obama lifted the
ban will be discharged.

Regardless of what happens on a policy level, Trump's
tweets have brought to light some questions and misconceptions
about what it means to be transgender. Here's what you need to
know.

Sex versus gender

Transgender is an umbrella term that describes people whose
gender identity is different from the one they were assigned at
birth.

The terms sex and gender, while often used interchangeably, are
not the same.

A person's sex refers to whether they are biologically male or
female — an assignment given at birth based on physical
characteristics, including chromosomes and reproductive organs. A
person's gender, on the other hand, refers to their internal
sense of gender, which can fall on a spectrum.

People who identify with the gender that matches their sex are
called cisgender. People who identify as neither male nor female,
or somewhere else on the gender spectrum, may describe themselves
as nonbinary or genderqueer.

Gender dysphoria is a condition in which a person
experiences distress because their assigned sex does not match
their gender identity. However, there is a
consensus within the medical community that the diagnosis and
treatment should be medical rather than psychiatric.

Young
retired as an Army major in 2013.YouTube/Screenshot

How someone knows they are trans

People can realize they are transgender at any point in
their lives,
according to the National Center for Transgender Equality.
Some make this distinction at puberty or earlier, while others
take years to understand their gender identity, sometimes because
of fear, shame, or confusion.

Healthcare for transgender people

Trump's tweets said that transgender people serving in the
military would cause "tremendous medical costs and
disruption."

But it's important to note that not all transgender people
want or pursue transition-related medical treatment. If they do,
the medical care they seek depends on their preferences. Care can
include hormone-replacement therapy or gender-confirmation
surgery,
according to the American Medical Student Association.

RAND Corporation's analysis found that the financial costs of
allowing transgender people to serve would be low, considering
the military's overall healthcare costs. By its estimate, between
29 and 129 of the US military's 1.4 million troops would most
likely seek gender-confirmation surgery annually. The procedure,
which can include a hormone process, anesthesia, and a hospital
stay, can cost upward of
$100,000 without insurance.

On July 13, the House
defeated a proposal that would have prevented the Pentagon
from funding gender-confirmation surgery and hormone therapy for
service members. The RAND report estimated that if
transition-related services were extended to active-duty
personnel, the military's healthcare costs would increase by
between $2.4 million and $8.4 million a year — at most a 0.13%
increase over the $6.2 billion the Defense Department spent on
healthcare for active-duty personnel.

The Department of Veterans Affairs, which has a separate
budget, seeks to spend $69 billion on
medical care in fiscal 2018.

Members
of the 30th Heavy Separate Brigade of the North Carolina Army
National Guard.Reuters

Serving in the military as a transgender person

According to
a 2014 survey by the NCTE and the National Gay and Lesbian
Task Force, about one-fifth of all transgender adults are
veterans, making transgender people approximately twice as likely
as others to serve in the military, The Washington Post
reported.

A
2014 article published in the academic journal Medical Forces
& Society concluded that transgender service members were as
deployable and medically ready as their cisgender peers, with few
exceptions.

"As noted in other sections of this article, cross-sex
hormone treatment and mental health considerations do not, in
general, impede the deployability of transgender service members,
and the public record includes instances in which transgender
individuals deployed after having undergone transition," the
researchers wrote.

Transgender active US service members have been able to
seek transition-related care since 2016. But RAND estimated that
less than 0.1% of the US military would do so with a disruption
to deployment. The report also suggested that trans people had a
"minimal likely impact" on force readiness, a measure that
includes factors like unit cohesion and physical ability.

"We found that that transgender people serving in the
military had a negligible impact overall," Radha Iyengar, a
senior economist at RAND, told Business Insider. "Australia, the
UK, Israel, and Canada allow openly transgender people to serve.
Looking at the factual numbers, we don't think there's any
evidence that allowing open service would be costly or affect
military readiness."

Evan
Young, the director of the Transgender American Veterans
Association and a former Army major, told Business Insider that
hiding his trans identity during his 14 years of military service
was emotionally draining and that the ban on transgender people
in the military "impacted me a lot."

"I hid during 'don't ask, don't tell,'" he said. "As soon as that
was lifted, I realized I was transgender, and I stayed in the
closet. For my entire military career, I had been closeted. It
affected me severely mentally. I couldn't bring my partner to any
functions. And when I started taking testosterone, I could
visibly see the changes, and I know my commander could, too. I
was a recluse. It was very tough."

Rob
Morris, a member of the Lesbian, Gay, Bisexual, Transgender,
Questioning, and Allies Club at Norwich University, the nation's
oldest private military academy.Reuters

What happens now?

The Pentagon appears to not have known about Trump's policy
reversal before Wednesday morning.

Senior officials in each branch of the military had in
recent months voiced opposition to integrating transgender people
into troops,
Military Times previously reported. But many politicians and
veterans have strongly opposed Trump's reversal of the Obama-era
policy.

Democratic Rep. Dan Kildee of Michigan, a vice chair of the
congressional LGBT Equality Caucus,
called the decision a "slap in the face to the thousands of
transgender Americans already serving in the military."

Republican Sen. John McCain of Arizona, a veteran himself,
also denounced Trump's decision.

"Any American who meets current medical and readiness
standards should be allowed to continue serving," McCain said in
a statement. "There is no reason to force service members who are
able to fight, train, and deploy to leave the military —
regardless of their gender identity."

When asked what would happen to deployed transgender
military personnel around the world, White House press secretary
Sarah Huckabee Sanders
said it was "something that the Department of Defense and the
White House will have to work together on as implementation takes
place."

Aaron Devor, the chair of transgender studies at the
University of Victoria in Canada, said Trump's ban on transgender
people in the military was unlikely to be upheld in court should
it face legal challenges.

"Trans military personnel serve bravely and loyally in 18
countries around the world," he told Business Insider. "Trump's
rejection of trans troops in the US has no basis in objective
evidence. This is bald-faced and counterproductive reactionary
bigotry. This ban will be overturned in the courts. Hatred will
not win in the long run."